Tag: chronic pain

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Reduce Pain by Changing Your Outlook

If you know me, you know I love to look at research studies. Sure, they have their limitations, but it’s really cool to see things we intuitively know are good for us proven under the scrutiny of the scientific method!

Take, for example, a recent review of the literature that studies the role of a positive outlook on pain. This study is from the Clinical Psychological Society in the Netherlands.

They found that a positive outlook significantly reduces pain, and reduces sensitivity to painful events.

For people with chronic pain or other painful conditions, they found that positivity can also optimize the effectiveness of other treatments.

Wow! That is pretty amazing. But if you’re anything like me, you’re thinking,

“Well, it’s pretty hard to be happy-go-lucky when you’re in pain! How am I supposed to do that?”

This is especially true if you have chronic pain that you’ve been dealing with for a long time. It’s hard to not let that get you down, and understandably so.

So how can we use this research to make change in our pain and our lives?

My prescription for you is this:

decide, right now, that you are your own first priority.

Yup, that’s right. Before you start thinking of reasons to put yourself second (or third, or fourth…or last), consider this:

When you get on a plane, don’t they tell you to put your own oxygen mask on before helping other people? That’s because you’re not much good to anyone if you’re passed out in the aisle!

Taking care of yourself is like putting your oxygen mask on. You need to be okay before you can be there for other people in a meaningful way. Otherwise, you will end up resentful to those you intended to help, and/or you will burn out. If you REALLY want to be there for the people you love and the causes you care about, you MUST take care of yourself first.

There are so many simple, quick and effective ways to reduce your levels of daily stress, and thereby improve your mood and your outlook.

Some of the things you can do to boost your mood are quick reminders that you can include easily in your day on the fly, and others you have to plan for. Let’s take a look at both.

On the Fly Mood Boosters

I’m gonna give you some daily, stress-busting reminders to try.

Your job is to pick one or two that you can really do over the next week.

Write the one you pick on a post-it and stick it on a mirror, the refrigerator, your desk, or anywhere else you know you’ll see it a lot. You can even post reminders in more than just one place!

After a week, take a moment to notice if anything has shifted in you since you started this practice.

You might keep up with it as it is, change your reminder, or just modify yours a little. It’s your daily ritual, make it how you like it!

List of Reminders For Your Post-It:

  • “Breathe” (long slow inhales, longer slower exhales)
  • Be willing to not have all the answers.
  • When you’re feeling stressed, ask yourself, “what is the most important thing right now?”
  • Pick a different energy- whimsy, joy, playfulness, or one of your own choosing- and call it into your mind and heart.
  • Remove extra minor stressors when you find them (e.g. driving just a little too fast…it’s weirdly stressful!).
  • Be willing to ask for help when you need it.
  • If you’re pushing yourself to complete a self-imposed task, ask yourself, “will this matter in a year?”
  • Take several slow, deep breaths before each meal.
  • Remind yourself to “slow down” more often.
  • Pretend that you’re at your “vacation job” or your “vacation home,” or in your “vacation car.” How would you act differently if this was exactly what you wanted to be doing, where you wanted to be? If you CHOSE this?

Plan Your Relaxation Time

While it’s good to have little reminders in the day, nothing can match the power of actually scheduling time in your day to do something to take care of you. And, for most of us, if you don’t schedule it in your calendar, it won’t get done.

So grab your favorite pen, your planner, and block out some time for yummy self care!

Here are some ideas you can choose from, or you can come up with your own self soothing experience 🙂

Planned Ways to Reduce Stress

  • Practice this Active Rest Pose for 5 minutes, a few days a week.
  • Practice self empathy for a few minutes, especially if you are feeling down.
  • Take a nap!
  • Go for a walk outside. If possible, try not to look at your phone (or not bring it if you can!).
  • Buy yourself some flowers.
  • Leave early for an appointment and enjoy the journey getting there.
  • Go for a walk with your dog or child, and let them lead the way. Stop where they stop, notice if you feel impatient, and let them teach you how to slow down and savor the moment.
  • Use all your paid time off!
  • Read a book (that’s not related to work or self-improvement!)
  • Eat your lunch outside, and JUST eat. (try not to look at your phone, read, or listen to something).
  • Plan a “frump day” where you stay home all day in your comfy, frumpy clothes and do whatever you feel like. Watch movies, do some stretching, bake some cookies, take a bath.
  • Write a handwritten letter to someone you care for and haven’t seen in a while. Use special stationary that you like.
  • Lie on the couch for a few minutes. Not to listen to a podcast, sleep, or text. Just be there.
  • Take a 5 minute stretch break at work- make sure you’re breathing!

Not all of these may appeal to you, but I’m sure some of them do! Incorporating some spontaneous and some planned relaxation into your day can make a huge difference in your outlook, your pain, and your overall experience of life.

After all, what’s the point of all this if you’re not enjoying some of it along the way, right?

Keep taking care of yourself, and the world will reward you.

May you find ease in your body! I’ll be there rooting for you the whole way.

– Dr. Derya

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5 Day Restorative Yoga Challenge!

It’s a Rejuvenation Revolution!

Happy Spring! I have had much more time to contemplate and reflect during quarantine life, and am making the most of time at home with my hubby and doggie. I hope you are able to find some light in this uncertain situation, too.

I’m feeling inspired by the new season, the birds are singing, the flowers are blooming! I’m excited for everything this season has in store for me and for you as well. In fact, I’ve gotten so inspired that I made an awesome challenge to rejuvenate your body and spirit in under 15 minutes a day (more on that below)!

Whether you know me from the clinic, or have been following along here on the blog, you’ll know that I am all about taking realistic small steps to finding peace and ease in your body rather than looking for a miracle cure.

I’m a firm believer that little bits of self care lead to lasting change. Why? Because it works.

Real change—in our lifestyle, our mindset, our breath, our lives—doesn’t happen all at once. If you’re anything like me, you love the intoxicating hope and energy that comes with creating big, amazing goals. But at some point, we have to take the first step!

Now that it’s spring, a time of rebuilding and growth, it’s especially important to go step by step!

As we emerge from our winter cocoon into a more active lifestyle, it’s important to do this with grace and gentleness so that we can be present for our loved ones, and for ourselves. It’s easy to go full force and then find yourself burnt out before you even really got started. Trust me, I’ve been there! When that happens, those exciting goals might lose a bit of their allure. Luckily, that’s where the small changes I keep mentioning come into play!

Every change you manifest in life (big and bold, slow and steady—it all counts) starts with a decision. You decide you want to go after or create something, then you start walking that path. The key is to start where you are and just begin.

There’s something magical in those first small steps, no matter how baby they are. I think it’s time to honor those small steps.

So, as spring sets in, I’ve got an idea for you: Instead of going full speed ahead, let’s reserve some of that time for self care, so that you can keep moving forward in a calm and centered way!

I’m calling it the Rejuvenation Revolution!

I’m not saying you shouldn’t go after all those amazing and fun things you have planned for this spring and summer (you absolutely should!), but it is time for those plans to share your brainspace with your wellbeing, today.

Not your wellbeing next month or next year—your wellbeing now.

I’m talking about finding simple ways to nourish and care for yourself today. About taking simple, doable actions that bolster you up rather than wear you down. You might be surprised what’s possible when you put the next 6 months aside and focus on caring for yourself in this very moment!

Not sure where to start?

Join me for my 5 Day Restorative Yoga Challenge! If you haven’t experienced the power of restorative yoga before, you’re in for a treat! It’s the perfect opportunity to choose one small thing you can do for yourself now.

Instead of huge lifestyle changes, we’ll simply be adding one simple, relaxing restorative yoga posture to our day for 5 days. No prior experience necessary! I talk you through each exercise with enough detail for complete beginners (but don’t worry, I don’t gab the whole time)! It’s a fabulous way to kick-start this more active season with a steady, consistent energy with a focus on taking care of YOU.

Because no matter what your big goals for this spring and summer may be, adding just one restorative yoga pose a day to your routine will set you up for success in mind, body and soul. It’s a small step you can take today towards creating a healthy habits that will sustain you all year long.

When you join the challenge, you’ll get 5 restorative yoga postures to help you regain energy, be more calm and focused, relax your body and feed your soul! Just because we’re taking small steps doesn’t mean we can’t go after big, lovely results, right?!

When you join, you’ll get:

  • Each day for 5 days you’ll receive one restorative yoga posture with a guided video in your email.
  • You’ll also get tips on how to make the most of each posture and modifications if you need ’em. 
  • Oh, and did I mention that all the videos all take less than 15 minutes to complete?

Say “YES” to Rejuvenation! Join the 5-Day Restorative Yoga Challenge!

It always helps to have accountability buddies on board, it’s one of the keys to success! So share this challenge far and wide!

This is your chance to give yourself some soothing, well-deserved care. Trust me, your body and mind will thank you.

Join me on this challenge today! I’ll be there to rest, restore, and replenish with you every step of the way.

With love,

Dr. Derya

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Listening to Your Body: Why It’s So Hard!

I wasn’t always an active person. In fact, growing up I was a total bookworm. I hated sports, I was the slowest person in gym class, and I spent most afternoons curled up with a book or watching TV.

In high school I started working out and watching my diet, and it felt really good! I was also getting more attention from classmates, the cool girls and guys who had never noticed me before were striking up conversations and inviting me to hang out. I even joined some sports teams.

Naturally, I became very attached to my great liberator, exercise. How could I not? It made me feel great, bolstered my social life, gave me energy, and all the other merits that we constantly hear about exercise.

But, there was also a dark side to this life changing health decision.

Exercise and Attachment

This last month I have been sick. Not terribly ill, but definitely not able to run and workout like I want to. And I think I have prolonged my illness to some degree by still pushing myself more than I should have. For me, I am so attached to the boost I get from exercise, that when I don’t have that in my life I start to get really down on myself. I have a good base in meditation and mindfulness practice, but I am still human and I still have my attachments. It takes quite a bit of work for me to “take it easy” and “listen to my body.” And how do you even “listen to your body” anyway?

woman feeling exhausted at work
Do I need a break, or should I keep pushing? (hint: you probably need a break!)

I hear it all the time, “listen to your body, if you need to rest, rest.” But then I also hear the opposite, “push yourself, when you are feeling tired, that’s the time to push even harder!” And, to be honest, I mostly end up just following the advice that suits my mood in the moment, but that’s not always the healthiest choice.

For example, in this recent bout of illness, my body was telling me to slow down, nap, drink tea and CHILL. But I hate the feeling of being unproductive, and when I don’t workout I feel that inner child bookworm creeping up. Or rather, I could say that I am attached to the feeling of being productive, and instead of asking how I could console this inner child that is struggling, I am pushing her away.

It doesn’t sound so good when I put it that way. But that’s the reality of it. To really understand how to actually listen to our bodies, we have to first talk about wanting vs attachment.

Getting Past the “Shoulds”

When I am really listening to my body, most of the time I still want to work out. I love the way it makes me feel, the health benefits I get, and the joy of moving my body in the great outdoors. The difference is that I am not attached to working out, because I can tune in and listen to my sensations and trust my intuition. So, if I get signals from my body that I need to rest, nap, take more time to relax, I can listen to that instead of shaming myself out of it. This is the goal, but that takes practice.

The most common way we disregard what our bodies are trying to tell is by shaming ourselves. My favorite guilt trip is, “Wow, you are being so lazy. You had so much you were going to get done today, and you’re just going to nap? How dare you! When everyone else in the world is out there working!”

Pretty mean, huh? If I talked that way to my friends, I probably wouldn’t have any. But it is not uncommon for us to talk to ourselves in this way. How can we allow for that? It stems from attachment, to the way we think we should act, should look, should engage with our world.

In order to be able to connect with our intuition, a.k.a. be able to “listen to my body,” we have to learn how to let go. To let go of the “shoulds” and get back to our sensations in the present moment.

Learning to Let Go: Two Versions of the Self

Letting go is hard. It’s hard because we feel like we are going to fall apart without the things that hold us together. For me, working out on a regular routine is one of those things. Part of me feels that if I skip a week or two of working out, I’m going to be horribly out of shape, feel awful, and be a hypocrite (because a lot of my job as a physical therapist is teaching people about exercise!). This is the part of me I call the Fear Self. But there’s another part of me that knows I’m going to be okay. This second part is what I call the Rational Self. She looks at the big picture, and knows that I will get back to working out when I am better, that by taking a real break I will heal faster and get back to my routine faster. The rational self is rooted in truth and fact instead of fear and worry.

At first, the fear self is always louder. She comes up with all sorts of reasons to be concerned, sad, and frustrated. She is small minded and short term focused.

The rational self is quieter, she’s always there but needs to be called upon to speak up. By seeing the long term results and the reality of the situation, she can make good decisions without being influenced by self imposed “shoulds.”

How To Quiet the Fear Self

To connect with your rational self means to listen to your body, in a real and non-superficial way. In order to do this, we need to first identify our fear self. By naming our fears and worries, we can clearly see how irrational and unhelpful they are. The next time you find yourself criticizing yourself, acknowledge that this is the Fear Self. Tell her that you see her, and you appreciate her concern for you, but you’ve got this one under control.

Here’s an example:

Fear self: “You are not even sick, you are just being lazy. You have all this time to be working on projects and getting fit and you’re not using it! You’ll never get this opportunity again!” (hint: all-or-nothing words like “never” are a clear sign that the fear self is talking).

Me: “Okay, I see you, Fear Self. Thank you for looking out for me, but I am doing what is best for me right now.”

It doesn’t help to get mad at or blame your Fear Self. That will just have the opposite effect. Instead, think of your Fear Self as a scared child, who needs comforting and consolation, not to be yelled at or scolded.

*Remember: listening to your body starts with being kind to yourself.

Of course, you won’t be able to catch every critical comment, but whenever you are able to go through the process of calling out the Fear Self, you are developing new neural connections that make it easier to do the next time. It is a skill to cultivate and hone.

Once you’ve identified the fear self, she loses her power. Just by naming it, you begin to see the fears and worries for what they are: intangible ways of keeping us stagnant in our old patterns. To move forward, to grow and expand as a human being, we need to connect with the rational self.

How to Connect with the Rational Self

Once the fear self is quiet, the rational self can emerge. Let’s stick with the example above.

Fear self: “You are not even sick, you are just being lazy. You have all this time to be working on projects and getting fit and you’re not using it! You’ll never get this opportunity again!” (hint, all-or-nothing words like “never” are a clear sign that the fear self is talking.

Me: “Okay, I see you, Fear Self. Thank you for looking out for me, but I am doing what is best for me right now.”

Connecting with your rational self and listening to your body

From this point, I can ask the Rational Self, “what do I really need to do right now? Am I being lazy, or am I actually sick?” Then I focus on the area of my belly or chest, and wait until I get an answer. This also takes some practice, but really it doesn’t work if you over think it. Just ask, focus on the center of your chest, and see what comes up. For me, the answer way, “Girl, you are actually sick! Rest up!” And when I heard that my thought was, “Duh! How have I been ignoring this obvious advice?”

The harder part is actually listening to that advice. And I promise you, if you continue to not listen, your body will make you listen. In the past, I’ve pushed myself to the point where I HAD to lay in bed for a while. That is my old pattern, to keep pushing and ignore those signals to slow down. I’m not perfect, that’s for sure, and it takes effort for me to change this pattern. Of course, doing the things the way we’ve always done them is easier. It’s an inertia, you’ll keep going the way you were always going unless some effort is applied in another direction.

So, as for me, I’m still working on taking it easy, and listening to those signals from my body. Sometimes I don’t want to listen, and I give in to the Fear Self. But I keep trying, and I’m getting better.

With all the latest diets, pain “cures” and workouts at our finger tips, it can be really hard to decide what works for you and what doesn’t. But the more you can connect with your Rational Self, your True Self, the easier you will be able to navigate decisions about what is best for you.

Have you ever struggled with the Fear Self, or had trouble listening to your body? I’d love to hear your story. Share your story by leaving a comments below.

May you find ease in your body.

Derya

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Whiplash, Pain, and the Brain.

Earlier this week it snowed a lot. Then it melted, and froze overnight. And when I took my dog out for her morning walk, well, you can probably guess what happened. I didn’t make it 20 feet from my door before my feet slid out from under me on a patch of ice and I landed hard on my butt, with my head being painfully snapped back. I was, of course, a little stunned and went back to my house to survey the damage. No broken bones, just some bruises. Over the next few days I monitored myself for signs of concussion, which , thankfully, there were none, but what I did have was a painful stiffness and ache in my neck when I tried to move my head. “Oh great,” I thought. Whiplash.

An Icy Morning.

When I first walked into my house after slipping on the ice, these were the thoughts in my head, “oh no, you have a delicate neck. This is going to be so bad. You are going to be dealing with this for months. What if you have another concussion? That’s going to really mess you up…” and on and on.

Luckily, I had the knowledge and training to know that these thoughts would be the most significant factor in my speed and completeness of my recovery. Even though it was hard, I started to change my self talk. I said to myself, “this is not that bad. You’ll get over it soon with a couple days for your strained muscles to heal. You didn’t hit your head, and there are no signs that anything is seriously wrong. You’re going to be ok.”

At first, I didn’t believe these words I told myself, but I kept up with it. And, over the course of the day, I started believing a little bit of it. But more importantly, my body felt less tense and guarded. Now, three days later, my neck pain is almost completely gone. I didn’t have to go to a chiropractor or have needles stuck in my neck. I didn’t have to do any special exercises except some breathing to calm my nervous system. I didn’t even have to change my daily activities and still did what I would usually do, including exercise.

Of course, it’s not always that easy, and it has not always been the case for me to get over neck pain that quickly. I have had many neck injuries of varying severity, and the pain of them has plagued me for many years of my life. I tried everything, acupuncture, chiropractic, and of course several physical therapists. Those all helped, but my neck pain never really went away until I changed the way I thought about my pain. I know, I know, it sounds like I’m saying, “it’s all in your head.” Which is just not true. But, it is true that a lot of it is in how your head and your body talk to each other.

Pain and the Brain

You see, the brain determines levels of threat, and sends signals to our body on what to do accordingly. When your brain perceives high threat, it starts emitting neurotransmitters that tell your body to tense, to breathe more shallowly, and halt healing processes.

This is actually really good. For example, let’s say you’re a wild human and you get attacked by a tiger. You find yourself bleeding and injured, and your brain knows that it needs to get your muscles tensed and ready to go so that you can hoof it back to your village before you die in the middle of the prairie. (Do tiger’s even live on prairies? Anyway, you get the idea). Your brain, in that moment, is not worried about healing. Healing occurs when you get back to the village and your wounds can be tended, you are safe.

But what if you never get to the village? What if the stress of getting attacked by a tiger is replaced with the stress and worry that’s associated with chronic neck pain, the fear that you will never get better, the threat of having to deal with a stiff neck on top of all the other things you are having to deal with in your life right now?

In this scenario, your body never gets a signal to relax, to soften your tensed muscles, to release a cascade of neurochemical transmitters that promote healing. You become caught in a troublesome feedback loop: your muscles get’s tense, which causes your brain to percieve threat. As a result of that percieved threat, your body get’s more tense. And on and on, until you find yourself dealing with months to years of pain with no one able to explain to you why it won’t go away.

Getting out of the Cycle of Pain

I have been there, in that loop. I have a tendency to go back there, maybe it’s just how I’m wired. I have to actively, consciously, change the way I think about my body and pain in order to subvert that loop. And it works. I also use relaxation techniques and mindfulness meditation practices to assist me in this process. But what has been so fascinating to me is that this is the missing link in healing from chronic pain, and, perhaps more importantly, preventing it in the first place.

This is not news to the medical community; there have been plenty of studies linking a patient’s outlook on recovery to how well they actually recover. This mind body connection is starting to become more popular in pain management, but in most cases it is not emphasized or even acknowledged in our healthcare system. Certainly, there are appropriate times to seek invasive modalities or even surgery, but shouldn’t we start with an intervention that is very low risk and potentially very high reward in regards to resolution of symptoms?

I have created some resources to help you manage your pain and to prevent yourself from developing chronic pain syndromes. It starts with being able to sense and feel your body, in a non-threatening way. This will allow your brain and body to get out of the cycle of threat and pain and back into fluid, alternating, reciprocating motion.

Getting Back in Your Body

A great place to start getting back in your body is with this simple 5 minute Guided Body Awareness Technique. (You should try it, it’s really relaxing!)

Five Minute Body Awareness Exercise.

Remember, pain is not just in your body, and it’s not just in your brain. Whoever says that mind and body are two separate things is just wrong. You can’t treat one and not the other and expect to change the patterns that we live in. If you find yourself in chronic pain, be kind and gentle with yourself. Reconnecting with the sensations in your body is the first step to letting go of these stuck patterns.

May you find ease in your body.

– Dr. Derya

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